Wilson Gomer M.D. Professional Medical Corporation
LBN: Wilson Gomer M.D. Professional Medical Corporation
Wilson Gomer M.D. Professional Medical Corporation is an health care organization with primary practice located at 1800 Western Ave Ste 103 , San Bernardino CA 92411. The organization recently has only one registered license in Ambulatory Health Care Facilities / Health Service, which is considered as the primary health care specialty.
Wilson Gomer M.D. Professional Medical Corporation can be contacted via phone (909) 887-7427, or through Gomer, Wilson D via phone (909) 802-9374.
Contact Information
Primary practice address
1800 Western Ave Ste 103
San Bernardino CA 92411
Phone: (909) 887-7427
Fax: (909) 887-7430
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Health Service | 261QH0100X | A50690 | California |
Profile Details
| NPI number | 1104327543 |
|---|---|
| LBN Legal business name | Wilson Gomer M.D. Professional Medical Corporation |
| DBA Doing business as | |
| Authorized official | Gomer, Wilson D Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 21st, 2018 |
| Last updated | Jun 6th, 2018 - about 6 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104327543 | NPPES |
| California | MEDICAID | 00A506900 |
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